Whenever it comes to cartilage loss, anabolic hormones such as testosterone play a role in regenerating it. Research shows that estrogen receptors are present in cartilage and that estrogen stimulates cartilage growth.1

Similarly testosterone has been shown to have a direct effect on cartilage growth. Testosterone, for example, is an anabolic hormone (i.e. synthesized into living tissue). Anabolic hormones, which are responsible for protein synthesis, enhance production of muscle and cartilage growth. Many people believe that testosterone is only a male hormone, but it actually plays a pivotal role in the female body chemistry as well. If one has a low testosterone level, then they will likely experience more difficulty healing.

Testosterone is made by men in the testicles, and females the ovaries. There is also a small production that is created in the adrenal glands. Although the adrenal gland is able to produce a small amount of testosterone, many patients of both genders suffer from depleted adrenals as a result of stress. This stress can arise from pain, lack of sleep, and a myriad of personal issues. So sometimes treating adrenal fatigue to optimize hormone production is called for.

A Swedish study recently focused on the effects of testosterone on chondrocytes to determine whether testosterone was dependent on the stage of maturation or was gender specific. The research concluded that testosterone promotes differentiation of chondrocytes (cartilage cells) and increases collagen production. It was dependent on time of exposure, presence of serum, gender, and stage in chondrocyte maturation. It also mentions that age, height and weight are associated with sex steroid levels.2

In another study, researchers examined whether testosterone supplementation could help prevent total knee replacement. They looked at various factors that can affect knee cartilage volume. Earlier studies had shown that tibial cartilage volume in healthy men decreased 2.8% per year. They were particularly interested in measuring serum testosterone levels and total bone mineral content. They hypothesized that hormonal manipulation and/or treatment with bone antiresorptive drugs could reduce cartilage loss/osteoarthritis in men. They found that, “serum testosterone level at baseline and urinary NTx, a marker of bone turnover were inversely related to cartilage loss.”3

So again, it seems like there may be a correlation between optimal testosterone levels and healthy cartilage.

In one landmark study, doctors showed how androgens (anabolic hormones) reversed cartilage damage and reduced proteoglycan loss. Women are two to three more times more common and more likely to have the disease become more disabling and aggressive than men. It suggests that a long-term androgen replacement may help prevent joint damage and disability.4

The Role of Melatonin

Doctors at Sun Yat-sen University in China recently published research in the journal Advances in free radical biology and medicine in which they suggested melatonin could alter the disease joint environment of the knee.

Cartilage repair by mesenchymal stem cells (MSCs) often occurs in diseased joints in which the inflamed microenvironment impairs chondrogenic maturation (prevents cartilage growth) and causes neocartilage degradation (the diseased environment of the knee does not allow new cartilage to develop.

In this environment, melatonin exerts an antioxidant effect by scavenging free radicals. The results of introducing melatonin into the diseased knee environment demonstrated that proinflammatory cytokines impair the chondrogenesis of MSCs (inflammation destroying cartilage), was reversed by melatonin treatment. Melatonin provides a new strategy for promoting cell-based cartilage regeneration in diseased or injured joints.5